| NPI | 1609006592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A104289) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 13910) |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2020-01-30 |